A population-based analysis of gender differences in survival outcomes for gastric gastrointestinal stromal tumors

Although gender-based differences have been demonstrated to affect the prognosis of multiple tumors, their specific influence on the survival of gastric gastrointestinal stromal tumors (gGISTs) at the population level is still uncertain. Consequently, we aimed to investigate gender disparities in the prognosis of gGISTs using the Surveillance, Epidemiology, and End Results (SEER) database.

Patients with gGISTs from the years 2000 to 2019 were retrieved from the SEER database. To minimize selection bias, propensity score matching (PSM) was used. Kaplan-Meier analyses and Cox proportional hazard models were used to assess the influence of clinical characteristics on overall survival (OS) and cancer-specific survival (CSS).

A total of 3006 patients with gGISTs were analyzed, including 1459 males and 1547 females. Compared with female patients, male patients exhibited a higher proportion of Whites, more advanced T stage, larger tumor sizes, and elevated mitotic index. Before PSM, male patients experienced significantly worse OS (hazard ratio [HR], 1.55; 95% CI, 1.33-1.81; P <.001) and CSS outcomes (HR, 1.61; 95% CI, 1.28-2.02; P <.001) than female patients. Furthermore, they had lower mean OS and CSS rates at the 1-, 3-, and 5-year follow-up intervals (P <.05). Even after PSM, male patients continued to show poorer OS (HR, 1.30; 95% CI, 1.10-1.54; P =.002) and CSS outcomes (HR, 1.34; 95% CI, 1.05-1.70; P =.016) than female patients, with persistently lower mean OS and CSS rates across the 1-, 3-, and 5-year follow-up intervals (P <.05). For males without distant metastasis, 5-year OS was 78.8% and CSS was 90.0%, both lower than females' 85.5% and 93.7% (P <.05). For males with distant metastasis, 5-year OS was 48.7% and CSS was 58.8%, similar to females' 55.4% and 65.3% (P >.05). Multivariate Cox regression analysis identified age, race, gender, M stage, surgical intervention, tumor size, and mitotic index as independent risk factors for both OS and CSS.

Patients with gGISTs exhibit distinct clinical characteristics between males and females, with female patients showing a tendency toward improved OS and CSS. Surgical treatment has the potential to enhance the prognosis of patients with gGISTs.